The Pinstriped Bible

Johnson battling for much more than a roster spot

ONE MORE CYCLOPSOn Sunday, it was reported that Yankees camp attendee Jason Johnson had been treated for ocular cancer. This information may not have seemed of much significance to most of you, because Johnson is a 35-year-old non-roster invitee with a career major league ERA of 4.99, but it caught my eye–my one functioning eye–because I am a survivor of the same disease. We underwent the same treatment at the same hospital with the same doctors.

Like me, Johnson really shouldn’t have this disease. Statistically, ocular melanoma doesn’t strike anyone with regularity, just five or six cases per million people are afflicted each year, and then it seems to go for blue-eyed guys over 50 years of age. I was about 32, and brown-eyed. I don’t know what color Johnson’s eyes are, but he’s obviously a bit young. Further, ocular cancer doesn’t correspond to your diet, how much sun you get, whether you’ve been smoking asbestos or some other controlled substance in your college dorm room, or overly personal relations with your cat. It just happens.

The process is much like skin cancer: the inside of your eye can develop freckles or moles, just like your skin. Sometimes, those freckles or moles turn evil and will kill you if left alone for too long. If you see a mole on the back of your hand start to change shape or color, it’s a simple matter to head for the dermatologist’s office and have it lopped off and biopsied. If you get to it early, that’s usually the end of it–if the doctor gets clean borders when he removed the thing, that particular threat is gone for good. This same process happens in the eye, but you can’t see it, and the process is otherwise asymptomatic–by the time the cancer gets big enough to start messing with your vision, you could be in real trouble. My tumor was considered to be of medium size–it was only 8 millimeters thick. That’s nothing in the real world, but in the eye it’s a big object, and I had no idea it was there.

I caught mine because my eye doctor made a lucky find while looking for something else. Johnson’s doctor caught his under similar circumstances, while working him up for a new set of contact lenses. We’re both very, very lucky. If you catch the tumor while it’s still contained to the eye, your prognosis is much better than if it’s started to climb out of there. That said, even if the disease is contained to the eye, you’re still in trouble, because first, it has to be cured, and second, the longer it was in your body, the more likely it is that it sent off a colony somewhere. Melanoma is a capricious disease–those cells can hide for years or even decades before coming back to kill you, most likely by invading your liver or your lungs. There is no safe harbor–with some cancers, if you’re free of the disease for five years, you can consider yourself cured. With melanoma, you’ll be going for scans of those two body parts for the rest of your life. I do this every six months.

The good news about ocular melanoma is that it generally responds to being irradiated; not too long ago, the “cure” was enucleation, the removal of the eye. You get to keep it now, for what it’s worth. Johnson and I underwent the same procedure. You’re knocked out, the eye is squished aside, and a radioactive plaque is affixed to the tumor site. You then get to stay in-hospital for as many days as the plaque is affixed–you can’t go home because you’re a danger to others. In my case, the tumor reacted the way it should, shrinking rapidly, and sometime later the doctors baked what was left with a laser, just to make sure it was dead, dead, dead. After these procedures, it is very rare that the cancer recurs at the original site. It’s the colonies you have to be afraid of.

In my case, over time the radiation also took the sight in the afflicted eye. I won’t go into five years of medical treatment trying to save my vision, but in essence, the radiation that wasn’t good for the tumor isn’t good for the healthy parts of your eye either. I can’t speculate on Johnson’s outcome because I don’t know where in the eye his tumor was located. Mine was right near the optic nerve, which means that some important hardware got baked along with the cancer. His might have been off to the side somewhere, and perhaps he’ll have fewer complications than I have had, and he’ll get to retain his vision, or some portion of it, for longer than I did. One would hope that he will retain good vision throughout the remainder of his professional baseball career, as a pitcher who was not able to fully gauge the ball coming off the bat would be a sitting duck and just one bad read away from having his head blown off by a line drive.

I feel ungrateful complaining about my partial blindness. It beats being dead, after all, and that’s pretty much the choice I was offered. You’d trade one eye for the rest of your life any day of the week. Still, there’s rarely a day that goes by that I do not notice it in some way, am not inconvenienced by it. There have been some promising things reported about someday using stem cells to revive the optic nerve. I eagerly await the day such miracles are possible. In the meantime, I regret that I get to welcome Jason Johnson to the club, congratulate him on having his tumor discovered in time for treatment, and wish him many future years of healthy living and successful pitching.

Finally, I hope my story, and Johnson’s, encourages the rest of you to go out and get your eyes checked on a regular basis–not by your mall optometrist, but by a real ophthalmologist. This disease can blind you and it can kill you. Twice a year I head to the Wills Eye hospital in Philadelphia for follow-up examination. There’s some physical discomfort involved, but there’s a whole additional level of pain that results from those who often share the waiting room with me–children. I guess Johnson and I aren’t the only ones for whom eye cancer stepped aside of its preferred group to clutch at. This is, as they say, a word to the wise.

Speaking of Johnson yesterday, Joe Girardi said, “I had never heard of anyone having that.” Very few people have heard of ocular cancer, and most people react with shock and surprise when I first tell them about it. Now you know, so no excuses–keep up those eye exams, and tell them the Pinstriped Bible sent you.

You make me feel lucky! My cancer was on my shoulder, a slow mover that would recur in the same place if it does at all. When the lump was first removed, there edges were not clean; they ended up cutting out a larger area leaving a scar from the base of my neck to the top of my shoulder. At least the scar should direct people’s eyes away from my over sized pasta belly when I go down the shore this summer! I have a yearly visit now, and after another 3 years I will be considered cured. But just hearing your doctor say the ‘C’ word is perspective changing for sure.

Steve – Thanks for another great and entertaining article that combines Yankees baseball and raises awareness of Melanoma. Although the version of the disease I suffer from (a malignant rectal nodule that spread to my lymph nodes before it was found) is different from either yours or Jason Johnson’s, I think awareness of all forms of the disease is so important. I’d really admire the tenacity and creative survival techniques these tiny cells have evolved if they weren’t currently doing their best to try to kill me.

Anyway, most people know about Melanoma as a skin cancer. Spend too much time in the sun, get a weird mole, have it removed, maybe a little chemo, easy to cure, right? Not so fast! Only “easy” to cure if it’s still a surface skin lesion that’s caught pretty early. Once malignant Melanoma has metasticized elsewhere inside the body, chances of long-term survival drop rapidly. Malignant, metastatic melanoma is one of the hardest cancers to cure. It rates right up there with Pancreatic cancer. There’s so much more to know and the general public is woefully under-informed about this type of cancer. All due respect intended to breast cancer, but I wish there were more of a profile for “our” cancer club too. Thanks again for putting more information out there.

By the way, did you know the ribbon color for melanoma is black?!!? What a kick in the butt! You might as well give me a cancer ribbon that says, “Girl you are sooo screwed!”. There are eighty-million colors out there! Can’t the American Cancer Society pick a ribbon color for Melanoma that doesn’t say funeral? Maybe something in a nice Spring green to at least give us some hope? I’ll get off my soapbox now…

Thanks for the very educational column on this rare cancer. One question you might be uniquely qualified to answer as both a baseball blogger and a survivor of this cancer – Can Jason Johnson really hope to pitch professionally again? I would think the lack of vision in one eye, and the corresponding lack of depth perception, would make pitching, and especially fielding balls lined back up the middle, extremely dangerous. And given that there have been pitchers, like Bryce Florie, who have been hit in one eye by line drives, I’m not sure I’d want to risk one good eye by letting go of pitches 60 feet from a major league hitter. I would think that doctors and many coaches would strongly advised against him pitching again.

Meta

The following are trademarks or service marks of Major League Baseball entities and may be used only with permission of Major League Baseball Properties, Inc. or the relevant Major League Baseball entity: Major League, Major League Baseball, MLB, the silhouetted batter logo, World Series, National League, American League, Division Series, League Championship Series, All-Star Game, and the names, nicknames, logos, uniform designs, color combinations, and slogans designating the Major League Baseball clubs and entities, and their respective mascots, events and exhibitions.